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ACtORL?� CERTIFICATE OF LIABILITY INSURANCE
<br />F DATE(MM/DD/YYYY)
<br />1 4/12/2016
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsements .
<br />PRODUCER
<br />CONTACT Marie Swaney
<br />Dealey, Renton & Associates
<br />PHONE FAX
<br />. 626-844-3070
<br />199 S Los Robles Ave Ste 540
<br />E-MAIL renton.com
<br />, mswaney@dealeyrenton.com
<br />Y
<br />Pasadena, CA 91101
<br />INSURERS AFFORDING COVERAGE
<br />NAIC t/
<br />Lic #0020739
<br />INSURERA:Travelers Indemnity Co. of Connecti
<br />25682
<br />INSURED PROJEPART
<br />INSURER B :Travelers Property Casualty Co of A
<br />25674
<br />Project Partners
<br />INSURER C :American Automobile Ins. Co.
<br />21849
<br />23195 La Cadena Drive, Suite 101
<br />Laguna Hills, CA 92653
<br />INSURER D :U.S. Specialty Insurance Company
<br />29599
<br />INSURER E :
<br />949 852-9300
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: 1444432639 REVISION NIIMRFR-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DDWYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X� OCCUR
<br />Y
<br />Y
<br />6809361L110
<br />4/18/2016
<br />4/18/2017
<br />EACH OCCURRENCE
<br />$1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$1,000,000
<br />X
<br />MED EXP (Any one person)
<br />$10,000
<br />Contractual Liab
<br />X
<br />XCU Included
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY JECT LOC
<br />GENERAL AGGREGATE
<br />$2,000.000
<br />PRODUCTS - COMP/OP AGG
<br />$2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />BA93611_484
<br />4/18/2016
<br />4/18/2017
<br />MBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />I$
<br />ALL OWNED AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />HIRED AUTOS X NON -OWNED
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />XAUTOS
<br />$
<br />NOOWnedAUtoS
<br />B
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />CUP8833Y649
<br />4/18/2016
<br />4/18/2017
<br />EACH OCCURRENCE
<br />$1,000,000
<br />AGGREGATE
<br />$1,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION$0
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />N / A
<br />WZP81033771
<br />4/18/2016
<br />4/18/2017
<br />1 OTH-
<br />STATUTEI ER
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />E,L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />D
<br />Professional Liability
<br />USS1626677
<br />4/18/2016
<br />4/18/2017
<br />$1,000,000 Per Claim
<br />Claims Made Form
<br />$1,000,000 Annual Aggregate
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Umbrella policy is a follow -form to underlying Gen eral/Hired&Non-Owned Auto/Employers Liability Policies. AM Best's Rating for all policies
<br />listed are: A/XII or greater.
<br />The City of Santa Ana, its officers, employees, agents, volunteers and rep resentativesare named as additional insured as respects general
<br />and hired/non-owned auto liability for claims arising from the operations of the named insure s required per written contract or agreement.
<br />REVIEWED BY:' E UN11C E Fi Rt:L" IA (PC C O k
<br />%,cR I Ir R,M IG nULUF_rc %,AIVI.GLLA I IUIN UU UdV IV\J1-,I I UdV IUI IVUI Ir-dV UI r'IUIII
<br />City of Santa Ana
<br />120 Civic Center Plaza - M36
<br />Santa Ana CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />f'tiP7s , r y
<br />U 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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